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DiscriminationandMentalHealth–RelatedServiceUse in a National Study of Asian AmericansMichael S. Spencer, PhD, MSSW, Juan Chen, PhD, MSW, MA, Gilbert C. Gee, PhD, Cathryn G. Fabian, MSW, MA, and David T. Takeuchi, PhD, MAAsian Americans are one of the fastest-growingracial groups in the United States and also oneof the most understudied.1Recent data fromthe National Latino and Asian American Study(NLAAS), the first national study of AsianAmericans, show that they have a sizeable bur-den of mental illness, with a 17.30% overalllifetime rate of any psychiatric disorder anda 9.19% 12-month rate.2At the same time, lowutilization rates of mental health services byAsian Americans are well documented.3–7Na-tionally, Asian Americans/Pacific Islanders areone third as likely as Whites to use availablemental health services.3Low use rates have beenreported for emergency and inpatient services4–6as well as outpatient services.4,7,8In the United States over a 12-month period,only 3.1% of Asian Americans use specialtymental health services, compared with 5.59%of African Americans, 5.94% of CaribbeanBlacks, 4.44% of Mexicans, 5.55% of Cubans,and 8.8% of the general population.9–11Ina study by Abe-Kim et al., only 8.6% of AsianAmericans sought any mental health servicescompared with 17.9% of the general popula-tion.12Kimerling and Baumrind found that AsianAmerican women were less likely than Whitewomen to report perceived need for mentalhealth services, even when accounting for fre-quency of mental distress. Among women whodid perceive a need to seek mental healthservices, Asian American women were less likelyto use services even when health insurance wascontrolled.13Despite low use rates for formal services,research has established that Asian Americansare more likely to use informal support systemsfor help with mental health issues as to useformal services. Data from the Chinese Amer-ican Epidemiology Study (CAPES) found thatof Chinese Americans experiencing mentalhealth problems in the past 6 months, fewerthan 6% saw mental health professionals, 4%saw medical doctors, and 8% saw a minister orpriest.14A study using data from the FilipinoAmerican Community Epidemiological Study(FACES) found that of the 25% of FilipinoAmericans who used any type of care in thepast 12 months, 17% went to the lay system (afriend or relative), 7% used medical doctors, 4%saw a clergy member or indigenous healer, andonly 3% saw a mental health specialist.15Ina study using data from the CAPES, negativeattitudes toward formal mental health serviceswere correlated with more informal serviceuse.16Discrimination is a major stressor experi-enced by American ethnic groups.17Experi-ences with discrimination shape one’s appraisalof the world and hinder the ability to controlone’s environment, thus reinforcing secondarysocial status and internalizing negative stereo-types.